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All about: Pramipexole dihydrochloride

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Generic name: Pramipexole dihydrochloride
Brand names: Mirapex

Why is Pramipexole dihydrochloride prescribed?

Although it is not a cure, Mirapex eases the symptoms of Parkinson's disease--a progressive disorder marked by muscle rigidity, weakness, shaking, tremor, and eventually difficulty with walking and talking. Parkinson's disease results from a shortage of the chemical messenger dopamine in certain areas of the brain. Mirapex is believed to work by boosting the action of whatever dopamine is available. The drug can be used with other Parkinson's medications such as Eldepryl, Sinemet, and Larodopa.

Most important fact about Pramipexole dihydrochloride

If you are taking Sinemet or Larodopa, Mirapex may allow a reduction in your dosage. And if you suffer from the "on-off" effect that often develops during Parkinson's therapy (symptom-free periods alternating with severe attacks), Mirapex may extend the good "on" times and shorten your "off" periods.

How should you take Pramipexole dihydrochloride?

Take Mirapex exactly as prescribed. If it makes you nauseous, try taking it with food.

When discontinuing Mirapex therapy, it's best to do it gradually. Your doctor will tell you how to taper your dose over a week's time.

--If you miss a dose...

Take it as soon as you remember. If it is almost time for your next dose, skip the one you missed and go back to your regular schedule. Do not take 2 doses at the same time.

--Storage instructions...

Store at room temperature; protect from light.

What side effects may occur?

Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Mirapex.

  • More common side effects may include:
    Abnormal dreams, arthritis, chest pain, confusion, constipation, decreased sensitivity to touch, difficulty breathing, difficulty walking, dizziness, dizziness upon standing, drowsiness, dry mouth, hallucinations, increased muscle tone, increased urination, insomnia, involuntary movement (jerky motions), lack of appetite, memory loss, nasal inflammation, nausea, swelling, urinary tract infections, vision abnormalities, weakness

Why should Pramipexole dihydrochloride not be prescribed?

If Mirapex gives you an allergic reaction, you'll be unable to use it.

Special warnings about Pramipexole dihydrochloride

Mirapex can cause your blood pressure to drop when you first stand up, resulting in symptoms such as dizziness, nausea, fainting, blackouts, and, sometimes, sweating. To avoid or reduce these symptoms, try to stand up slowly, especially at the beginning of treatment with Mirapex.

Mirapex can cause drowsiness and may trigger hallucinations, especially if you are over 65 or have an advanced case of Parkinson's. You may even fall asleep--without warning and without feeling drowsy--while performing everyday activities. Check with your doctor immediately if you find that you're getting drowsy or falling asleep while eating, talking, or watching television. Do not drive a car or undertake other dangerous activities until you've spoken with the doctor. Be especially cautious when taking other drugs that cause sleepiness.

If you have a kidney condition, make sure the doctor is aware of it. You'll probably need regular blood tests to check your kidney function, and your dosage of Mirapex may have to be reduced.

In very rare cases, Mirapex may cause muscle wasting. If you develop muscle aches or soreness after you start Mirapex, be sure to tell your doctor. Also alert your doctor if you notice any changes in your eyesight.

Possible food and drug interactions when taking Pramipexole dihydrochloride

If Mirapex is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Mirapex with the following:

Carbidopa/Levodopa (Sinemet)
Sedatives and tranquilizers such as chloral hydrate, codeine products, Dalmane, Halcion, and phenobarbital
Cimetidine (Tagamet)
Diltiazem (Cardizem, Dilacor XR)
Major tranquilizers such as Compazine, Haldol, Mellaril, Navane, Prolixin, Stelazine, and Thorazine
Metoclopramide (Reglan)
Quinidine (Quinidex, Quinaglute)
Quinine
Ranitidine (Zantac)
Triamterene (Dyrenium)
Verapamil (Calan, Isoptin)

Combining Mirapex with Sinemet or Larodopa sometimes triggers twitching and jerky movements. If this happens, tell your doctor. A reduction in your dose of Sinemet or Larodopa may solve the problem.

Special information if you are pregnant or breastfeeding

The effects of Mirapex during pregnancy have not been adequately studied, so it's best to avoid it if you're expecting. If you are pregnant or plan to become pregnant, inform your doctor immediately.

It is not known whether Mirapex appears in breast milk. If the drug is considered essential to your health, your doctor may advise you to stop breastfeeding while taking the medication.

Recommended dosage

ADULTS

The usual starting dose is 0.125 milligrams 3 times a day. If necessary, your doctor may increase the dose every 5 to 7 days until the maximum dose of 4.5 milligrams a day is reached. Dosage is usually increased gradually to minimize the drug's potential side effects. If you have kidney disease, the doctor will keep the dosage quite low.

CHILDREN

The safety and effectiveness of Pramipexole dihydrochloride in children have not been established.

Overdosage

Although there is no information on Mirapex overdose, any medication taken in excess can have dangerous consequences. If you suspect an overdose, seek medical attention immediately.

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